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Can eye bags be removed without blepharoplasty? Eyelid Surgery Sydney

29 Sep

Lately, an increasing number of lower eyelid bags, dark circles under eyes and tear trough deformities are being treated without surgery. In this blog I’ll discuss the best treatments that will improve your look.

Development of loose eyelid skin and 'bags' are the two most common signs of ageing in the lower eyelid. The eyebags are in most cases due to an outward bulging of the fat pads behind the lower lids. The eye floats in the bony eye socket on thick fibrous fat that is held back by a strong membrane. With ageing, the membrane weakens and is no longer able to hold the fat back, resulting in the fat drifting forward, bulging and causing the 'eye bags'. In addition, the shrinkage of bone and the loss of cheek fat can reduce the volume under the eyes, deflate the skin beneath the eyes, and much like a balloon that has lost its air, the skin can crinkle and billow outward into small bags. This makes the eyebags prominent and stand out. 

Types of treatments available

Restore volume

Since the eye bags are made to look more prominent by the loss and displacement of volume (fat and bone) from the area under the eye, one quick, non-surgical solution is to restore volume. A variety of dermal fillers including Perlane, Juvederm, Ultra Plus, Radiesse and Esthelis have been used successfully in this way. Treatment typically takes only a few minutes per side and the results are immediate with no downtime. Owing to the thin skin under the eyes, bruising, mild swelling and redness are common but temporary, typically lasting only a few days.


Mesotherapy employs multiple injections of pharmaceutical medications into fat, to dissolve the fat under the eye. When it was launched it offered the perfect solution. Although it works, it is inconsistent and unpredictable. The inconsistency and unpredictability makes it less attractive in treating eyebags.

Fat repositioning and fat grafting

The loss of volume (fat and bone) from the area under the eye creates a dark circle or depression beneath the lower eyelid. Fat repositioning as a part of lower eyelid surgery or fat grafting into the depression beneath the lower eyelid may help. Fat grafting can be performed as a stand alone independent surgical procedure where the fat is taken from the belly, processed and injected into the area of concern. In some cases lower lid 'bags' can be improved by repairing or reinforcing the soft tissue that normally holds them back.

Transconjunctival Lower Blepharoplasty

If the fat under the eye is confined to a localised area, a transconjunctival approach to the problem can be very effective. These 'bags' of fat can be improved by conservative removal through an invisible incision on the inside of the lower lid. This type of surgery does not require a skin incision in your lower eyelid but one on the inside of the lid. A small incision is made and the excess fat can be removed without leaving a trace that the procedure was ever performed. The reduction (NOT total removal) of lower lid fat pads should be conservative. Excessive removal of lower lid fat pads results in a hollowed-out appearance that can make a person look tired or even ill. The biggest risk of blepharoplasty of the lower eyelid is the weakening of the lower eyelid support by the incision on the outside of the lower eyelid which can lead to ectropion (lower eyelid turning outward) and change in eyelid shape. The transconjunctival lower blepharoplasty uses an incision on the inside of the lower eyelid, thus lower eyelid support is preserved.

In general, it is possible to address eye bags and fat without surgery; however, in some cases a surgical procedure may be the preferred option. It’s important to do your research before proceeding with any procedure and consult with one or more experienced Plastic Surgeons.

Do you have any questions you need answered on eyelid surgery but are not yet ready to financially commit to a one on one consultation? I invite you to join me for a free information evening where you can ask me your questions in an intimate and friendly group atmosphere. Click on the button below to learn more about the evening and to reserve a seat.

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Dr Naveen Somia MBBS, PhD, FRACS

Written by Dr Naveen Somia MBBS, PhD, FRACS

Dr. Naveen Somia is a Sydney Plastic Surgeon who listens to his patients, understands their problems and works alongside them to help achieve their aesthetic goals by applying his skills and years of experience in Plastic and Cosmetic Surgery. A published author on Plastic and Cosmetic Surgery, Naveen’s blog is aimed at helping you make the right choices and stay safe in your quest to look your personal best.